DESCRIPTION: The primary goal of this training fellowship is to prepare the candidate for a research career as a successful independent investigator devoted to eliminating racial and ethnic disparities in the health of African-Americans with hypertension. Specifically, this training will provide the candidate an opportunity to: 1) engage in extensive study and research training focused on examining the relationships among spirituality, medication adherence (ADH), and blood pressure (BP) in hypertensive African-Americans, and 2) conduct an independent research project through the guided mentorship of Dr. Jennifer Pinto-Martin, PhD, MPH, Dr. Barbara Riegel, DNSc, FAAN, CS, RN, Dr. Gbenga Ogedegbe, MD, MPH, MS, and Dr. Jacqueline Mattis, PhD. The specific aims of this study are to: 1) determine the role of spirituality in ADH to antihypertensive medications in African-American patients followed in primary care settings, and 2) test spirituality as a moderator of BP control in hypertensive African-American patients followed in primary care settings. The hypotheses tested are: 1) among hypertensive African-American patients followed in primary care settings, those with increased levels of spirituality will have increased levels of ADH, and 2) among hypertensive African-American patients followed in primary care settings, those with increased levels of spirituality will have decreased BP. The specific aims will be accomplished through patient self-reported measures of spirituality and ADH and an objective measure of BP with a well-validated automated digital BP monitor. This study will employ a cross-sectional correlation design nested within the context of an ongoing NHLBl-funded study of BP control among hypertensive African-Americans. The significance of this study lies in its potential to serve as a basis for the development of spiritually based and culturally appropriate interventions designed to improve blood pressure control and ultimately reduce the racial burden of hypertension-related adverse outcomes in this patient population.